iPhone 6: Doctors Raise Concerns Over Apple HealthKit

The iPhone 6 launch is just weeks away, but there will be much more than just one or two new phones. Of greater importance to most iPhone and iPad users is the accompanying release of iOS 8.
Apple has heavily reworked its mobile operating system and the biggest change will be a drive into fitness. It is a move which has doctors concerned.

Apple HealthKit In A Nutshell

Apple’s health offering is called ‘Healthkit’ and connects with both the sensors in your phone (like a gyroscope counting steps) and third party products from the likes of Nike, Fitbit, Wahoo and Withings. HealthKit will display all their information in one phone with an easy to read dashboard and Apple has also said it is working with the Mayo Clinic in the US and the Cambridge Trust in the UK to connect your results with your GP or even to contact a hospital proactively.

HealthKit will work with the iPhone 4S, fifth generation iPod touch, iPad 2 and above (older models won’t get iOS 8), but the iPhone 6 will be the centrepiece and driving force for HealthKit as it will have an array of new sensors expected to deliver far greater health monitoring capabilities.

Apple HealthKit Third Party Integration

On the surface HealthKit sounds great, so what is it that is raising wider concern in the medical industry? (sources 1, 2, 3, 4, 5). I spoke to two medical professionals to find out:

Dr. Dushan Gunasekera is a medical graduate of St. Bartholomew’s Hospital who left medicine to become a healthcare financial services advisor. He runs his own practice at the myHealthCare Clinic in Battersea, London and works with the Regent’s Park Heart Clinics.

Accuracy and Generalisation

“One thing that is a problem is the purported accuracy of the data,” explains Gunasekera. “Whilst having this data could be of use, a doctor is unable to guarantee that whichever blood pressure monitor, glucose monitor or fitness tracker a patient is using will be accurate. Because of this, it’s unlikely that we’ll ever be at a point where a doctor will take a look at your phone and be able to give a diagnosis.”

Kapila agrees: “The app needs to be programmable in an individual way specific for the patient with individual limits set. Not everybody will be expected to achieve results within the normal range. Look at an athlete with a resting heart rate of 40 beats per minute, this is abnormally low for the majority of other people... there is no perspective available from raw data and interpretation by a doctor in relation to the patient’s overall medical condition.”

Complacency and Paranoia

“Apple Health will almost certainly affect the mentality of patients, however whether it will make them more paranoid or more aware is less clear,” says Gunasekera. “The key to Apple Health being useful all rests on the data produced being interpreted correctly. There is certainly a risk that people will see a sharp dip in one of their graphs and interpret that as a big problem, when in fact the reading could still fall within a normal range.”

“Some patients will develop anxiety over less than perfect figures and it could end up being an unhealthy obsession,” adds Kapila who also notes that “Those people that do focus on their health often do think they are healthier than they actually are. The mere act of inputting information about oneself into a tracker is psychologically very reassuring.”

“In relation to the group that might think they are healthy when not, I think this can be avoided if the app offers inbuilt safeguards to warn when action is needed. Numbers in isolation do not help users to know what’s important and what’s not” stresses Kapila.

“A further issue is with data protection,” says Gunasekera. “All medical records are now kept in software devices and whilst it might be beneficial for patients to have their own medical records on their smartphones, who owns this data has to be considered.”

But the good news is not all is doom and gloom.

Benefits for Diabetes and Pregnancy

“There is one particular condition that HealthKit works very well for and that is Diabetes,” argues Gunasekera. “Diabetics have to constantly measure their blood glucose level, which is traditionally done using a pinprick and a small about of blood being analysed with a portable device. But there are tiny monitors that can be implanted under the skin that can track blood glucose that could then be tracked using something like Apple HealthKit.

Having your iPhone alert you when your blood sugar falls too low would be a monumental lifestyle change for diabetics. No more would they need to manually check their levels, they would just need to glance at their smartphones – or wait for an alarm signal to go off.”

Gunasekera also sees major benefits for pregnancy. “Pregnant women have to keep an eye on exactly what they are eating and doing, throughout the 9 months,” he explains. “Monitoring something like heart rate would give mothers a way of ensuring their baby is doing well. There are ways to do this at the moment, but it involves regular prenatal checkups and there’s no real way of tracking stats in-between. By wearing a monitor at all times a mother could have her iPhone alert her if something was amiss.”

Kapila also points to HealthKit’s potential to help in the areas of oxygen saturation in COPD patients, asthmatics and those with sleep apnoea.

Apple HealthKit Medical ID

Education

Ultimately both professionals stress that education will be critical to the success or failure of HealthKit.

“When iOS 8 is launched, Apple will need to make an effort to show users what [HealthKit users] should be aiming for, failing that a patient’s doctor will have to... technology is certainly not yet at the point where it can replace a real doctor,” says Gunasekera. “The human body is a complex object that changes from day to day and from hour to hour. Being so complex means that it will take a trained professional to look at all of your stats to make a diagnosis if something is wrong.

Apple needs to make it clear that a Health app isn’t a replacement for regular checkups, it is instead a way of monitoring some of your stats in-between appointments that can affect your overall health.”

Health Vs. Fitness

And this is perhaps the crux of doctors’ arguments: presentation – because in name alone Apple HealthKit is not really about healthcare.

“Overall the categories lean far more towards fitness than healthcare,” says Gunasekera. “Tracking the intake of individual vitamins is all well and good for someone trying to balance their diet, but it doesn’t tell a doctor much about a patients overall well-being.”

“I can also see this being beneficial to anyone in sports and fitness and also for people who have had a health scare or wakeup call,” agrees Kapila. “We do a lot of annual medicals during which we can pick up new problems, for example high blood pressure, that need monitoring. iOS 8’s HealthKit would be ideal for that issue.”

“The upside is that if this motivates people to improve their fitness, their health should improve as well as a consequence,” concludes Gunasekera.

I am an experienced freelance technology journalist. I have written for Wired, The Next Web, TrustedReviews, The Guardian and the BBC in addition to Forbes. I began in b2b print journalism covering tech companies at the height of the dot com boom and switched to covering co...